Subcutaneous cardioverter-defibrillator implantation after cardiac surgery and endocardial device infection. Case report

Abstract

Introduction: The implant of a Subcutaneous Implantable Automatic Defibrillator (ICD) is not common in some countries due to their specific indications, the novelty of the technique and the device, the large infrastructure needed, and the high cost. In this paper, we present the 17th implantation of this device in our country.
Background: This is a man with heart failure with reduced ejection fraction (HFrEF) of ischemic etiology associated with mitral and tricuspid valve disease in whom coronary revascularization surgery, mitral valve replacement, and tricuspid annuloplasty were initially performed.
Results: During follow-up and after optimal medical treatment, a Subcutaneous ICD was implanted as primary prevention for sudden cardiac death; during follow-up, he developed an infection of the implant site, and after ruling out endocarditis, subcutaneous ICD placement was necessary.
Conclusion: This case exposes the clinical scenarios for the indication of a subcutaneous ICD, its effectiveness in reversing sudden death, and recovery after implantation.
Relevant points: Although the indications for Implantable Cardioverter-Defibrillator (ICD) placement are well established in both national and international literature, subcutaneous implantation of this device remains uncommon in our country. This case is relevant given the limited local experience and seeks to provide Mexican cardiologists with a clearer understanding of the indications and nature of the procedure.